Employee Personal Details

Personal Details
This information is private and confidential. All information required here is for the purpose to enter in contract of employment with us. Some information may be used to acquire further references such as a criminal check.
Name:*
Prefix First Middle Last
Have you ever changed Names?*
This information is used to obtain a DBS Check.
Date you changed names:*
MM slash DD slash YYYY
Previous Name:*
Prefix First Middle Last
What is your Mother's Maiden Name:*
This information is used to obtain a DBS check.
Telephone Number:*
Email:*

Address History
Current Address:*
Street Address Address Line 2 City State / Province / Region Post Code
Have you lived at this address for less than 5 Years?*
Previous Address:*
Street Address Address Line 2 City State / Province / Region Post Code
Date Moved in:*
MM slash DD slash YYYY
Date Moved Out:*
MM slash DD slash YYYY

Important Information:
This information will be used to obtain a DBS Check as well as entering you to our payroll system
Passport Number:*
National Insurance Number:*
Town of Birth:*
County of Birth:*
Date of Birth:*
MM slash DD slash YYYY
Emergency Contact Name:*
Prefix First Last
Relationship to you:*
Telephone:*

Bank Information
This information will be used to pay you.
Bank Name:*
Name on the account:*
Account Number:*
Sort Code:*
Privacy Policy*
- I give consent to Rosa Clean LTD to use my personal information for the purposes of my contract of Employment. I also understand information I have given will be used to carry out reference checks.
Data Withdrawal*
- I understand that if in future I would like to withdraw my details from the system I must return to this website and access the - Data Withdrawal Form.

Personal Details